Entire communities of earthquake survivors in Afghanistan and Pakistan were spending a third night without shelter in plummeting temperatures Wednesday

Entire communities of earthquake survivors in Afghanistan and Pakistan were spending a third night without shelter in plummeting temperatures Wednesday, with fears growing for children sleeping in the open as rescuers struggled to reach remote mountainous regions.

Rugged terrain, severed communication lines and an unstable security situation have impeded relief efforts since Monday's 7.5 magnitude quake ripped through the region, triggering landslides and flattening buildings. More than 380 people have been killed.

Desperate victims appealed for blankets, warm clothes and food after the quake leveled thousands of homes, forcing many to camp out in the open.

Pakistan's confirmed death toll stood at 267 with more than 1,800 people injured and 11,000 homes damaged, and authorities warn that the number could spike with many isolated regions still cut off.

The UN children's agency UNICEF warned that children in the earthquake-hit areas "are facing further deadly threats as extreme conditions and insecurity cut off communities from aid".

Western charities said the Taliban presence in Afghanistan was hindering relief efforts.

The militants on Wednesday claimed to have overrun the remote district of Darqad in the quake-hit northern province of Takhar, underscoring the fragile security situation facing relief workers.

The insurgents on Tuesday had urged aid organizations not to delay in delivering relief, and vowed their fighters would provide "complete help" in affected areas.

Afghan officials said 115 people were confirmed dead and hundreds more injured, with casualties reported from around half a dozen of the country's 34 provinces, and more than 7,600 homes reported damaged.

Desperate survivors were left marooned on mountaintops in Badakhshan, the remote province where the epicenter was located and where much of the territory is controlled by the Taliban.

The quake was centered near Jurm in northeast Afghanistan, 250 kilometers (160 miles) from the capital Kabul and at a depth of 213.5 kilometres, the US Geological Survey said.

 Aid agencies have stressed the need for greater disaster preparedness in war-torn Afghanistan, which remains extremely susceptible to recurring natural disasters such as floods, earthquakes and landslides.